Hepatoblastoma in an adolescent girl: A case report

Hepatoblastoma is the most common primary malignant hepatic tumour in children, occurring between the ages of 6months to 3years. It most often presents with a painless abdominal mass discovered accidentally in youngchildren. Occurrence in adolescents and adults is rare and is usuallyassociated with non-specific symptoms which often result in delayed  diagnosis and commencement of treatment. Abdominal pain preceding a rapidly progressive abdominal mass is a common pattern observed in adolescents and adults. The histologic type commonly seen in adults isassociated with a poor prognosis. We report the case of a sixteen year old girl who presented with abdominal pain and distension and jaundice of a short duration. She was well-nourished with marked hepatomegaly and ascites. Hepatic transaminases were highly elevated with deranged clotting profile. She developed features of hepatic encephalopathy and diedon the seventh day of admission. A Post-mortem histologic diagnosisof hepatoblastoma was made.Key words: Hepatoblastoma, adolescent, poor prognosi

Characteristics of clients accessing HIV counseling and testing services in a tertiary hospital in Sagamu, Southwestern Nigeria

Introduction: Client-initiated HIV testing and counseling has helped millions of people learn their HIV status. Nevertheless, global coverage of HIV testing and counseling programs remains low. This study describes the characteristics of clients who accessed HIV counseling and testing (HCT) services in Olabisi Onabanjo University Teaching Hospital, (OOUTH)Sagamu.Materials and Methods: A retrospective study of the clients accessing HCT services in OOUTH. Data was collected from clients using a client intake form. Pre-test counseling, HIV screening and post-test counseling were carried out. Informed consent and confidentiality were ensured. Data obtained were analyzed using SPSS 10.0.Results: A total of 2607 clients accessed our HCT services between May 1st 2008 and April 30th 2010. The clients were between the ages of 1 year and 90 years. The mean age was 33.3 ± 15.26. The median age was found to be 32.0 years, with the modal age being 30.0 years. 73.7% (1828) were non-reactive (negative result), 25.9% (643) were reactive (positive result), while 0.3% (8) were indeterminate. Among the reactive results, 9.3% (242) were males while 15.1% (394) were females.Conclusion: A fair uptake of HCT services was noted. More females accessed services than males. More positive results were seen among females than males (P<0.05).Recommendations: Upscale of HCT services to involve Sexually transmitted infections clinics and free-standing, client-initiated testing centers is necessary. Continuous AIDS education and risk reduction should be promoted

Health related quality of life and psychological variables among a sample of asthmatics in Ile-Ife South-Western Nigeria

Background: Assessment of health related quality of life (HRQL) has become central to assessing the selfperceived impact of physical and mental impairment on patient’s health. Studies have reported a high rate of psychological disturbances among asthmatics; however, the impact of these psychological factors on HRQL remains unexplored. Objectives: To assess the health related quality of life among a sample of asthmatics and to identify the psychological and clinical variables that affect quality of life among asthmatics. Method: A total of 81 patients attending the clinic were assessed using the Mini-Asthma Quality of Life questionnaire (Mini-AQLQ), and the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and clinical variables were also obtained from the patients, the lung function was assessed using Peak Expiratory Flow Rate (PEFR). Results: Mean age of all the patients was 35.22 (SD±14.36) with a mean duration of asthma symptoms of 17.5 (SD±14.4) years. Mean peak expiratory flow was 336 l/min (SD±74.12). Anxiety was present in 44.4% of respondents, while 40% of respondents reported the presence of depressive symptoms, 48.1% of the respondents reported low scores on the asthma quality of life questionnaire. Poor quality of life was associated with the presence of psychological symptoms, female sex, and lower educational level. Conclusion: Psychosocial variables are just as important as clinical variables as determinants of health related quality of life among asthmatics.Keywords: quality of life; asthma; anxiety; depression; psychosocia

Antiplasmodial volatile extracts from Cleistopholis patens Engler & Diels and Uvariastrum pierreanum Engl. (Engl. & Diels) (Annonaceae) growing in Cameroon

In a search for alternative treatment for malaria, plant-derived essential oils extracted from the stem barks and leaves of Cleistopholis patens and Uvariastrum pierreanum (Annonaceae) were evaluated in vitro for antiplasmodial activity against the W2 strain of Plasmodium falciparum. The oils were obtained from 500 g each of stem barks and leaves, respectively, by hydrodistillation, using a Clevenger-type apparatus with the following yields: 0.23% and 0.19% for C. patens and 0.1% and 0.3% for U. pierreanum (w/w relative to dried material weight). Analysis of 10% (v/v) oil in hexane by gas chromatography and mass spectrometry identified only terpenoids in the oils, with over 81% sesquiterpene hydrocarbons in C. patens extracts and U. pierreanum stem bark oil, while the leaf oil from the latter species was found to contain a majority of monoterpenes. For C. patens, the major components were α-copaene, δ-cadinene, and germacrene D for the stem bark oil and β-caryophyllene, germacrene D, and germacrene B for the leaf oil. The stem bark oil of U. pierreanum was found to contain mainly β-bisabolene and α-bisabolol, while α- and β-pinenes were more abundant in the leaf extract. Concentrations of oils obtained by diluting 1-mg/mL stock solutions were tested against P. falciparum in culture. The oils were active, with IC50 values of 9.19 and 15.19 μg/mL for the stem bark and leaf oils, respectively, of C. patens and 6.08 and 13.96 μg/mL, respectively, for those from U. pierreanum. These results indicate that essential oils may offer a promising alternative for the development of new antimalarials

A media framing analysis of urban flooding in Nigeria: current narratives and implications for policy

© 2017, The Author(s). A critical element of current flood management is the importance of engaging key policy actors when policy decisions are to be made. However, there is still only limited understanding of how narratives of flood management actors may influence flood management policies, even though there is a suggestion that actors can strategically use their narratives to influence policy directions. In a developing country like Nigeria, there are still questions around lessons that can be learnt from understanding the narratives of policy actors, to unravel the complex nature of strategies and policy directions in managing urban floods. To help fill these gaps, this paper uses quantitative content analysis to explore the frame of five policy actor groups (government, local communities, business, multilateral organisations and non-governmental organisations (NGOs)) as expressed in local and national newspapers between 2012 and 2016 to understand their narratives of causes and strategies to solve the problem of urban flooding in Nigeria. The narratives of government, local communities and businesses align with the premise that flooding can and should be prevented whilst that of multilateral and business actors champion adaptation strategies on the basis that flooding is inevitable and hence more energy should be directed at ‘living with water’—emergency response, damage reduction and the aftermath. The study also identified areas of potential consensus and conflict between direct actors such as government and local communities on the one hand and funders on the other. Better discussion among actors aiding understanding of contemporary thinking and local realities will aid policy-making and policy implementation in the Nigerian context. An important step will be in the collaborative design of an urgently needed ‘Nigerian policy on flooding’ which currently does not exist

Pattern of cervical dilatation among parturients in Ilorin, Nigeria

Objective : To evaluate the pattern of cervical dilatation in live singleton pregnancies with spontaneous onset of labor and to compare any differences among nulliparas (P ara 0) and multiparas (Para ≥1). Material and Methods : Descriptive statistics are presented for 238 consecutive labor patients with spontaneous onset, ≥37 weeks gestation, live singleton pregnancy and who had spontaneous vertex delivery at the University of Ilorin Teaching Hospital, Nigeria, from May 2004 to June 2004. Pre-labor rupture of membrane and referred cases were excluded. Results : The mean cervical dilatation on presentation and duration of labor before presentation in labor ward among nulliparas were 5.40 cm and 6.66 hours; and among multiparas, 6.45 cm and 5.15 hours, respectively, the overall mean being 6.12 cm and 5.63 hours, respectively. The average time spent to achieve full cervical dilatation from time of arrival in labor ward was longer in nulliparas (4.80 hours) than in multiparas (3.60 hours) (t test not significant; P> 0.05). Overall mean total length of first stage of labor was 9.36 hours, while the total length of first stage of labor was 11.03 hours and 8.53 hours for nulliparas and multiparas, respectively (difference is significant; t test P 0.05). No significant correlation existed between rate of cervical dilatation and maternal age, gestational age and fetal size. Conclusion : It is evident from this study that higher the parity the shorter the length of first stage of labor; however, significant difference existed only in the first half of first stage of labor between nulliparas and multiparas. Mean rate of cervical dilatation was greater than the WHO-specified and Philpott's lower limit of 1 cm/h in active phase of labor

Male involvement in breastfeeding promotion and protection: an assessment of male undergraduates’ views in Sagamu, southwest Nigeria: Breastfeeding and young men in Sagamu

Objective: Breastfeeding is a cost-effective and evidence-based public health intervention for the control of childhood malnutrition and its consequences. Partners’ support and attitude towards breastfeeding is an important determinant of breastfeeding initiation, continuity, and outcome. This study assessed the perception of breastfeeding and its support among male students in Sagamu, Nigeria. Method: A cross-sectional study was carried out among 300 male undergraduate students in Sagamu, selected via systematic sampling. Data were collected with the aid of a structured, self-administered questionnaire and analyzed using SPSS 21.0, with results presented as frequencies and proportions.  Result: The mean age of respondents was 20±3.5 years. All respondents felt it was important for women to breastfeed their infants; 42% of respondents felt breastfeeding interfered with work; 20% felt women should be entitled to paid maternity leave; 85% will support efforts to promote breastfeeding in public; 95% will encourage their partners to breastfeed while working outside the home; 92% will assist their breastfeeding partners with household chores. Conclusion: Respondents had a good perception of breastfeeding and were willing to support its practice at home, work, and in the community. Adequate engagement of men in nutrition education activities will be most effective in promoting and protecting breastfeeding

The Acceptance and the Perception of Mastectomy by Males whose Spouses are Diagnosed with Breast Cancer in South Western, Nigeria: Are male spouses an obstacle?

Of several modalities of treatments available for breast cancers, mastectomy is the most dramatic and traumatic. This is because it involves the removal of an organ of a woman's sexuality and with the attendant risk of marital disharmony. This study investigated the perception and the acceptance of mastectomy among male spouses of female patients with breast cancers. We prospectively recruited 108 participants from two teaching hospitals and a private hospital in South Western, Nigeria. The study recruited spouses of female patients newly diagnosed with breast cancers that were yet to have surgery. Relevant data were obtained through interview of the participants by the authors. The mean age of participants in the study was 44.34(±5.7) years. Less than half (48.1%) of the participants accepted the procedure for their female spouses prior to counseling which rose up to 84.3% after counseling. The main reason for declining mastectomy was disfigurement. Age greater than 65 years (p=0.0274), previous knowledge of mastectomy (p=0.0107) and counseling (p<0.001) were associated with higher acceptance rate while educational status, religion and social class showed no statistical significant difference. Spouses of patients with locally advanced diseases accepted mastectomy more readily for their female partners as compared to those with early and metastatic diseases (p<0.001). About 79% of those who accepted the procedure prior to counseling would exhibit negative behavior toward their partners. Majority of male spouses of females with breast cancers would not readily accept mastectomy for their female spouses and would have negative perception of their partners after mastectomy. We thus recommend that health care workers should involve men in breast cancer related education.Keywords: Acceptance, mastectomy, male spouse, female breast cancer and obstacl

Prevalence of hypertension in three rural communities of Ife North Local Government Area of Osun State, South West Nigeria

Rasaaq A Adebayo,1 Michael O Balogun,1 Rufus A Adedoyin,2 Oluwayemisi A Obashoro-John,3 Luqman A Bisiriyu,4 Olugbenga O Abiodun11Department of Medicine, 2Department of Medical Rehabilitation, Obafemi Awolowo University, 3Department of Adult Education, University of Lagos, 4Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun State, NigeriaBackground: The prevalence of hypertension is increasing rapidly in sub-Saharan Africa, but data are limited on hypertension prevalence. In addition, few population-based studies have been conducted recently in Nigeria on the prevalence and correlates of hypertension in both urban and rural communities. Therefore, we determined the prevalence of hypertension in adults in the three rural communities of Ipetumodu, Edunabon, and Moro, in South West Nigeria.Materials and methods: One thousand adults between 15 and 90 years of age were recruited into this cross-sectional study, over a 6-month period, using a multistage proportional stratified random sampling technique. Sociodemographic data and anthropometric variables were obtained, and resting blood pressure (BP) was measured using an electronic sphygmomanometer. Diagnosis of hypertension was based on the JNC VII guidelines, the WHO/ISH 1999 guidelines, and the BP threshold of 160/95 mmHg.Results: Four hundred and eighty-six men (48.6%) men and 514 women (51.4%) participated in the study. Their mean age, weight, height, and body mass index were 32.3±14.7 years, 62±13 kg, 1.5±0.1 m, and 23.02 kg/m2, respectively. The prevalence of hypertension, based on the 140/90 mmHg definition, was 26.4% (Male: 27.3%; Female: 25.4%). The prevalence of hypertension, based on the 160/95 mmHg definition, was 11.8% (Male: 13.5%; Female: 10.1%). There were significant positive correlations between BP and some anthropometric indicators of obesity.Conclusion: The prevalence of hypertension in the three rural communities was 26.4%, indicating a trend towards increasing prevalence of hypertension. There was also a significant positive correlation between anthropometric indicators of obesity and BP in this population.Keywords: hypertension, Nigeria, prevalence, rural communitie